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Cherry picking

Posted Nov 21 2008 4:27pm
Eight emergency calls, one conveyed, one cancelled, one sent packing and five requiring an ambulance.

The day starts with a RTC involving a car and a motorcycle. He (the motorcyclist) is clipped by her (the car driver) who is now sitting on a wall crying about it. It’s her first RTC in six years of driving and she is (understandably) upset, although no amount of reassurance on my part, or that of the crew in attendance, will persuade her that everything is okay. The motorcyclist turns out to be as hard as nails and is let off by God without a scratch. He bounced down the road, thus paying the penalty for trying to weave in front of the car during a right hand turn.

Then another tearful emergency call to a walk-in centre for a 46 year-old male who has chest pain. When I arrived I could see the cause of his chest pain – he was hyperventilating...and crying... a lot. His girlfriend is with him and she seems anxious but a little embarrassed too. I never found out why the man was crying so much and I only managed to resolve his state of panic by removing the paper bag given to him by the nurse and replacing it with oxygen, which did the trick. Please don’t write in about this, I explained the concept in an earlier post :-)

The crew arrived and removed him to hospital and I removed myself from the area...only to be called right back to the same walk-in centre. This time for a 22 year-old who was having an asthma attack. She must have walked in just after I left.

She was on a nebuliser when I arrived for the second time (the patients in the waiting room were getting worried I think) and her condition was improving. A recent chest infection had exacerbated her asthma (common enough) and her inhaler was next to useless as a result. Once she was stable and her breathing had improved sufficiently, I conveyed her and her friend to hospital myself; no need for an ambulance in this instance.

I was tempted to get a cup of coffee after that job and was well on my way when I received a call for a male, age unknown, apparently fitting and unconscious in the street. The street in question is in the location of some of my regular drug-abusing time wasters and so I thought it might be one of them causing a stir in the public domain again. I got on scene to find a known alcoholic sleeping on the pavement, as he always does. A young lad was waving at me frantically as if his world was about to end. I sounded the siren right next to my sleeping friend and he woke up. Wouldn’t it be great if all our calls were that easy?

I chatted to him about sleeping in areas where nervous members of the public are likely to call us and sent him on his way to another ‘bed’ – he wasn’t happy (they never are) and he threatened to thump the next person who called an ambulance when he was trying to sleep off his extra strong lager. How dare they?

Anyway, the concerned citizen saw what was going on and joined his other worried companions for a game of football in the road. It’s possible the drunken sleeper was simply in their way, or they needed another one to make goal posts.

By the time the crew turned up, Mr. Sleepy was stumbling away. I discussed the job with my colleagues on the ambulance and they promised to let me know if a ‘decent’ job came up. They were true to their words.

The crew pulled up alongside me and the attendant said that a ‘fall onto roof’ had just come in and would I like to join them. They were a Technician crew, so I could legitimately request to assist them. I called it in and I got permission to follow on.

The ridiculous road works slowed us down quite badly and it took us all of seven minutes to crawl two minutes up the road. We pulled in at a building site and were set upon by pale-faced construction workers. One of their mates had fallen from a height onto the roof of the six storey building and had sustained some sort of head injury. We had been asked to report for HEMS but thought we should wait until we had assessed the man’s condition first.

We climbed to the roof of the building and across the length of it, negotiating our way over some precarious areas of slate and glass to where the young man lay. He was about 22 years-old and was lying on his back in a v-shaped gulley near the edge of the building; any nearer the edge and he would have fallen straight down more than a hundred feet. He was conscious but there was blood coming from his mouth and he appeared to have an injury to his arm. On the basis of his injuries, the mechanism for other potential injuries and the complicated extrication we had ahead of us, my colleague called for LFB assistance while I confirmed our need for HEMS, just in case.

I began the assessment of the young man while equipment and personnel were brought to the scene. It was an extremely awkward place to conduct obs and treatment and standing on the angles of the roof made life hard on the legs after a few minutes.

The patient was stable and I cleaned his airway as best I could. He had fallen from a scaffolding board that he had erected between the main scaffolding structure and the roof itself, at a height of about twelve feet. He had tumbled onto the concrete ledge below and hit it face first, losing teeth and bits of his lips in the process, thus the blood coming from his mouth. He had also damaged his arm (probably broken his humerus) during the fall and was lying uncomfortably in the tight wedge created by the roof angles. He was in pain but he seemed neurologically and haemodynamically sound.

Once a few more colleagues had gathered, his neck was collared and I got on with IV access, anti-emetic, pain relief and fluids (KVO), with the help of a team leader and the EMT from the ambulance. The LFB arrived and raised their ‘cherry picker’ up the scaffold-enclosed front of the building to within a few feet of us, in preparation for the removal of the patient. There was no other way he could be brought down from the roof.

The HEMS Delta Alpha team arrived and were brought up using the cherry picker lift. Now we had quite a crowd gathered on the roof; the construction workers, who were helping out and ensuring our safety; a Duty Officer, a Team Leader, myself, two technicians, two doctors and two HEMS paramedics - quite a party.

I had been on the roof with the patient for almost an hour before we had him ready to go. He was now on a scoop stretcher and tied in securely (we hoped). I volunteered to go down with him on the cherry picker. This meant I had to hold on to the scoop all the way down to stop it from slipping or tilting over the edge, though I wasn’t sure what I was going to do if the thing actually did try to slip off. I was securely clipped in - the patient was not.

After a smooth descent to the ground and many sighs of relief, we got him into the ambulance and off to hospital. He was very lucky not to have been more seriously injured, especially where he had landed. Getting him out of there in less time than we did would have been unlikely, so time-critical injuries would have cost him – and us.

I was dusty and sweaty now and my equipment needed to be re-stocked, so I took the opportunity to take myself off the road until I was decent enough to serve the public again. I also got a cup of coffee out of the deal.

Then a 61 year-old in custody at a local police station required my attention for his chest pain. He was an angina sufferer but he didn’t look convincing at all. As with most of these ‘in custody’ calls, the reality is that the ‘patient’ is looking for a way out. This man seemed to acknowledge this but continued the charade when the ambulance crew arrived to take him to hospital.

I don’t mean to come across as uncaring but I don’t have much time for people who just can’t take their punishment if they have done something wrong – like shoplifters who feign chest pain / abdo pain / pregnancy and all sorts of things to get away from their predicament when caught. It makes no difference - they're still busted.

Of course, this man may have been experiencing a twinge of angina as a result of the stressful situation he was in but his acting was terrible and his face and body could not co-ordinate themselves properly for the ploy. Sorry, not convinced.

I was given a quick run up to Oxford Street for a 20 year-old who had fainted. The problem is, I was given a shop as the location and discovered that there were at least three of them on the same side of the street and Oxford Street is a long road. By the time I had worked my way through the traffic and sorted out one store from the other, the crew were on scene (after making the same mistake) and dealing.

My last call of the shift was for a 35 year-old male who was fitting in the street. When I got on scene I was waved down by the patient himself. He told me that he was fine and no longer required an ambulance. He explained that he was a diabetic and his blood sugar had run low as he was waiting for his meal at a restaurant (he had taken his insulin prior to ordering). His friends were with him and it was clear he was recovering but still wasn’t totally there yet.

I asked him if I could stick around and check his BM and he agreed. His BM was still low (2.3), so I suggested he ate something and I would wait with him until he recovered completely. I got the restaurant to send out some bread while he munched on a Mars bar, given to him by one of his friends.

The ambulance had been cancelled on this call and I was informed of this by Control as I pulled up, so there wasn’t going to be any further fuss made. I just wanted to ensure he was safe to carry on his day.

After ten minutes or so, the food brought his sugar levels up to near enough normal and that was that. He and his friends were off to the football match at Wembley – England vs Brazil. I offered my condolences to the losing team. :-)

Be safe.
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